Open Access

ARTICLE

Effect on sexual function of a vacuum erection device post-prostatectomy

Jason Douglas Engel

Department of Urology, George Washington University Hospital, Washington, DC, USA
Address correspondence to Dr. Jason Douglas Engel, Department of Urology, George Washington University Hospital, 2021 K Street NW, #408, Washington, DC, 20006 USA

Canadian Journal of Urology 2011, 18(3), 5721-5725.

Abstract

Introduction: Erectile dysfunction (ED) is a common complication following bilateral nerve-sparing robotic prostatectomy (BNSRP). Early intervention with tadalafil plus a vacuum erection device (VED) may enhance the recovery of sexual function compared to tadalafil alone.
Materials and methods: Men who underwent BNSRP for prostate cancer were randomized into two groups: one received tadalafil 20 mg three times weekly, and the other received the same dose of tadalafil plus daily use of a VED for at least 10 minutes unbanded per day, five days per week. Treatment began one month post-surgery. Clinic visits occurred at 1, 3, 6, 9, and 12 months. Patients were encouraged to attempt intercourse at least twice before each visit. At each visit, patients completed the International Index of Erectile Function (IIEF-5) questionnaire, a penile hardness scale (1–4), and were asked about their ability to achieve vaginal penetration and orgasm.
Results: Thirteen men started the combination regimen and none dropped out. Ten patients began tadalafil alone, but three discontinued treatment. The mean IIEF-5 scores at 6, 9, and 12 months were significantly higher in the combination group. Penile hardness scores were also significantly better at 6 and 9 months in the combination group. After 12 months, 92% of combination patients reported successful vaginal penetration compared to 57% in the tadalafil-only group. Corresponding figures for intercourse to orgasm were 92% and 29%, respectively. Compliance with VED use was higher than with tadalafil use.
Conclusion: In men experiencing ED after BNSRP, the combination of tadalafil and VED resulted in a more rapid and complete return of sexual function compared to tadalafil alone. This multimodal therapy may offer improved outcomes in early postoperative sexual rehabilitation.

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